About Vasculitis

Polymyalgia Rheumatica

What is Polymyalgia Rheumatica?

Polymyalgia Rheumatica (PMR) is an inflammatory disorder. It is frequently linked to Giant Cell Arteritis (GCA) occurring in 50 per cent of patients with GCA. Approximately 15 per cent of PMR patients develop GCA.

Who are affected?

The disease is usually diagnosed in patients over the age of 65. It is rarely seen in patients younger than 50. Women are twice as likely to develop PMR as men.

What is the aetiology (cause)?

The cause of PMR is not yet known.

What are the symptoms?

The symptoms usually come on over a few days. Symptoms include aching muscles and morning stiffness in the shoulders, hips, neck and mid-body. Other symptoms reported include: general tiredness, weakness, weight loss, low grade fever. Inflammation of the bones and joints can cause difficulty moving. Some patients develop swelling or fluid retention (oedema) of the hands, wrists, ankles and top of the feet.

normal shoulder joint and inflammation of shoulder joint

Making a diagnosis

There are no specific tests for PMR. Blood tests may show evidence of inflammation. Ultrasound and Positron emission tomography (PET scanning) have been used to confirm PMR inflammation. Patients with only PMR do not have the symptoms of GCA therefore a biopsy of the temporal artery (necessary in GCA) is unnecessary in PMR.

Treatment

Moderate to high doses of steroid drugs (prednisolone) improve the symptoms of PMR. The effective dose is maintained for several weeks after the symptoms have resolved. Then it is gradually lowered and stopped. Careful monitoring is required in case the symptoms recur.

Where long term use of steroids or side effects occur the use of Methotrexate may allow the dose of steroid to be reduced. Ibuprofen (an anti-inflammatory drug) can be used to reduce painful symptoms, especially when the symptoms are only mild.

Drugs and Side effects

For information on the main drugs prescribed for Polymyalgia Rheumatica see:

For information on other drugs used in the treatment of vasculitis see Glossary of drugs and side effects.

Prognosis

Relapse occurs in 25 to 50 per cent of patients. This is more likely if the steroid dose is reduced too quickly. Relapse requires restarting or increasing the steroid dose. In most cases the symptoms will cease within one month to one year. The steroids can then be discontinued.

Key Points

  • PMR is sometimes associated with Giant Cell Arteritis
  • Treatment is usually with steroids
  • Treatment may be able to be stopped once the disease is controlled.

Related Vasculitis Articles

Further reading

Useful links

Our Useful Vasculitis Links page contains contact details for organisations offering help and support for patients with Polymyalgia Rheumatica, Giant Cell Arteritis and other vasculitis diseases.

Download this page as a PDF

Vasculitis Patient Symposium 2015

News

A very Sad Loss for Vasculitis UK

13 Jun 2015

Pat Fearnside has died

Vasculitis and Lupus SLE Educational Evening Monday July 6th.

09 Jun 2015

Invitation to an educational evening at the Royal Free in London

RUDY Study

13 Apr 2015

A study in rare diseases of the bones, joints and blood vessels.

Events

Cambridge Vasculitis Support Group

04 Jul 2015

Information about the next support group meeting

South Wales Support Group summer informal meeting

04 Jul 2015

Please Join Jennifer and friends for this Summer party

High Tea for Vasculitis

11 Jul 2015

High Tea for Vasculitis

Vitality British 10k London Run

12 Jul 2015

See who will be entering this event for Vasculitis UK

David Golden is cycling for Vasculitis UK

26 Jul 2015

Blackpool to Scarborough, sea, sand and sunshine in 2 days - thats David's challenge.

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